Abstract
Lidocaine is deethylated in the liver to form Monoethylglycinexylidide (MEGX) which can be measured by Fluorescent Polarization Immunoassay. In order to determine if MEGX formation can be used as a quantitative liver function test, the MEGX concentration was measured in serum 15 min after lidocaine injection (1mg/kg IV) in 15 controls and in 40 patients with chronic liver disease (CLD). Salivary MEGX concentration was measured (at 15 and 30 min) in 10 controls and in 8 pts with CLD. Serum MEGX concentration was decreased in CLD compared to controls (38 ± 5 vs 106 ± 9 μg/L, X±SE, res-pectively) in an inverse proportion to severity of CLD: low risk for death (J Ped 111 : 479) 48±6 (n=28); medium risk 27±1(n=2); high risk 13±4 (n=10). Salivary MEGX concentration was decreased in CLD compared to controls (77±19 at 15 min and 155±31 at 30 min vs 103± 7 and 346± 74, respectively, p<0.5). serum MEGX levels at 15 min correlated with salivary levels at 15 and 30 min (r=0.43 and 0.34 respectively, p<0.05).
Conclusion: The serum concentration of MEGX is decreased in pts with CLD in an inverse proportion to disease severity. Salivary MEGX levels, which correlate with serum levels, are also decreased in pts with CLD. Assessment of MEGX after lidocaine injection may be a useful quantitative liver function test.
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Kader, H., Gremse, D., Berkowitz, D. et al. MONOETHYLGLYCINEXYLIDIDE FORMATION: A NOVEL QUANTITATIVE LIVER FUNCTION TEST. Pediatr Res 27, 542 (1990). https://doi.org/10.1203/00006450-199005000-00100
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DOI: https://doi.org/10.1203/00006450-199005000-00100